Two-year outcomes following a randomised platelet transfusion trial in preterm infants

Moore, Carmel Maria, D'Amore, Angela, Fustolo-Gunnink, Suzanne, Hudson, Cara, Newton, Alice, Santamaria, Beatriz Lopez, Deary, Alison, Hodge, Renate, Hopkins, Valerie, Mora, Ana, Llewelyn, Charlotte, Venkatesh, Vidheya, Khan, Rizwan, Willoughby, Karen, Onland, Wes, Fijnvandraat, Karin, New, Helen V., Clarke, Paul ORCID:, Lopriore, Enrico, Watts, Timothy, Stanworth, Simon and Curley, Anna and PlaNeT2 MATISSE Collaborators (2023) Two-year outcomes following a randomised platelet transfusion trial in preterm infants. Archives of Disease in Childhood-Fetal and Neonatal Edition, 108 (5). pp. 452-457. ISSN 1359-2998

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Objective: Assess mortality and neurodevelopmental outcomes at 2 years of corrected age in children who participated in the PlaNeT-2/MATISSE (Platelets for Neonatal Transfusion - 2/Management of Thrombocytopenia in Special Subgroup) study, which reported that a higher platelet transfusion threshold was associated with significantly increased mortality or major bleeding compared to a lower one. Design: Randomised clinical trial, enrolling from June 2011 to August 2017. Follow-up was complete by January 2020. Caregivers were not blinded; however, outcome assessors were blinded to treatment group. Setting: 43 level II/III/IV neonatal intensive care units (NICUs) across UK, Netherlands and Ireland. Patients: 660 infants born at less than 34 weeks' gestation with platelet counts less than 50×109/L. Interventions: Infants were randomised to undergo a platelet transfusion at platelet count thresholds of 50×109/L (higher threshold group) or 25×109/L (lower threshold group). Main outcomes measures: Our prespecified long-term follow-up outcome was a composite of death or neurodevelopmental impairment (developmental delay, cerebral palsy, seizure disorder, profound hearing or vision loss) at 2 years of corrected age. Results: Follow-up data were available for 601 of 653 (92%) eligible participants. Of the 296 infants assigned to the higher threshold group, 147 (50%) died or survived with neurodevelopmental impairment, as compared with 120 (39%) of 305 infants assigned to the lower threshold group (OR 1.54, 95% CI 1.09 to 2.17, p=0.017). Conclusions: Infants randomised to a higher platelet transfusion threshold of 50×109/L compared with 25×109/L had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. Trial registration number: ISRCTN87736839.

Item Type: Article
Additional Information: Funding: This work was supported by the National Health Service Blood and Transplant Research and Development Committee (reference number BS06/1); Sanquin Research, Amsterdam (grant PPOC-12-012027); Addenbrooke’s Charitable Trust; the Neonatal Breath of Life Fund 9145; the National Institute for Health Research Clinical Research Network; the National Maternity Hospital Foundation and the Health Service Executive.
Uncontrolled Keywords: neonatology,child development,intensive care units,neonatal,birth-weight infants,neonatal intensive-care,necrotizing enterocolitis,survival,intensive care units, neonatal,obstetrics and gynaecology,pediatrics, perinatology, and child health ,/dk/atira/pure/subjectarea/asjc/2700/2729
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 22 Mar 2023 10:30
Last Modified: 14 Jul 2024 05:33
DOI: 10.1136/archdischild-2022-324915


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